The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review

Saberi, Parya; Dong, Betty J.; Johnson, Mallory O.; Greenblatt, Ruth M.; Cocohoba, Jennifer

doi:10.2147/ppa.s30244

Cited by 88 publications

(101 citation statements)

References 42 publications

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“…Ambulatory care pharmacists practicing in HIV clinics have traditionally worked closely with other healthcare professionals to improve medication adherence with ART. 3,4,6,7,9,12 Patients with HIV are often vulnerable to having poor medication adherence, which could be attributed to increased pill burden, adverse effects from ART, lack of disease and medication education, and low threshold between non-adherence and risk of developing resistance to ART.…”

Section: Discussionmentioning

confidence: 99%

“…E-mail: r.vanmali@usciences.edu working as part of a multidisciplinary team. 4,5,6,7,8,9 March, et al described the impact of pharmacists' interventions on patient outcomes in a federally funded HIV clinic in Los Angeles, CA. At the conclusion of the study, patients being followed by the pharmacists in the clinic had a significant improvement in CD4 count, viral load (VL), and drug-related toxicities.…”

Section: 2mentioning

confidence: 99%

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The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

Vanmali¹,

Mayer²,

Fugit³

2013

Innov Pharm

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Results: Total of 32 patients accounted for 55 patient-pharmacist visits and 296 interventions. The most common interventions were medication review (66.9%), patient education (23.3%), and adherence monitoring (9.8%). Post-hoc analysis suggests Hispanic patients are more likely to be diagnosed with Acquired Immune Deficiency Syndrome (AIDS) (P = 0.01), have current or history of opportunistic infection (OI) (P=0.01), and have current or history of OI prophylaxis (P = 0.03). Adherence monitoring was less common amongst the non-Hispanics (7.1%) compared to the Hispanic sub-population (16.5%), (P = 0.04). Conclusion

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Section: Discussionmentioning

confidence: 99%

Section: 2mentioning

confidence: 99%

The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

Vanmali¹,

Mayer²,

Fugit³

2013

Innov Pharm

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“…8 If VL remains detectable after six months of initiation or modification of HAART, virological failure may occur, with risk of disease progression, accumulation of antiretroviral (ARV) drug resistance mutations, and less robust and durable elevation of LTCD 4 count, i.e., therapeutic failure. 5,9 In clinical practice, antiretroviral regimens may be changed due to therapeutic failure but also on account of adhesion difficulties, complexity of HAART, and other pharmacological factors (adverse reactions, drug interactions and toxicity). 1,9 At the São José Hospital for Infectious Diseases (HSJ-CE), approximately 3,944 PLWHA are assisted for treatment with HAART according to PCDT recommendations of 2013.…”

Section: Introductionmentioning

confidence: 99%

“…5,9 In clinical practice, antiretroviral regimens may be changed due to therapeutic failure but also on account of adhesion difficulties, complexity of HAART, and other pharmacological factors (adverse reactions, drug interactions and toxicity). 1,9 At the São José Hospital for Infectious Diseases (HSJ-CE), approximately 3,944 PLWHA are assisted for treatment with HAART according to PCDT recommendations of 2013. Due to the increasing number of PLWHA using HAART, treatment monitoring for the rational adherence of patients to therapy has become a priority, with improved clinical parameters and less risk of failure, hospitalization, costs, morbidity and mortality, longer survival and positive prevention with the adoption of healthy lifestyle habits.…”

Section: Introductionmentioning

confidence: 99%

“…Due to the increasing number of PLWHA using HAART, treatment monitoring for the rational adherence of patients to therapy has become a priority, with improved clinical parameters and less risk of failure, hospitalization, costs, morbidity and mortality, longer survival and positive prevention with the adoption of healthy lifestyle habits. [8][9][10] In this context, we aimed to describe the profile of HIV+ patients seen at a reference center in Fortaleza/Ceará, who had their initial antiretroviral regimen modified in the first year of treatment, and the factors involved in the modifications of HAART during this period.…”

Section: Introductionmentioning

confidence: 99%

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Antiretroviral changes during the first year of therapy

Bandeira

Elias

Cavalcante³

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction:The Brazilian HIV/AIDS management and treatment guideline (PCDT), published in 2013, recommends and standardizes the use of highly active antiretroviral therapy (HAART) in all adult patients, in spite of LTCD 4 count. This study aimed to analyze the first year of HAART use in patients from a reference center on HIV/AIDS management in Fortaleza, Ceará. Method: This descriptive study reviewed all prescription forms of antiretroviral regimens initiation and changes from January to July 2014. All antiretroviral regimen changes that occurred during the first year of therapy were evaluated. Data were analyzed with SPSS version 20. Mean, standard deviation and frequency, Student's t and Mann-Whitney tests calculations were used, with significance at p<0.05. Results: From 527 patients initiating HAART, 16.5% (n=87) had a regimen change in the first year. These patients were mostly male (59.8%; n=52), aged 20 to 39 years, with only one HAART change (72.4%; n=63). Efavirenz was the most often changed drug, followed by tenofovir, zidovudine and lopinavir/ritonavir. Mean time of HAART changes was 120 days, with adverse reactions as the most prevalent cause. HAART was effective in decreasing viral load since second month of treatment (p=0.003) and increasing LTCD 4 lymphocytes since fifth month (p<0.001). Conclusion:The main cause of initial HAART changes was adverse reaction and most patients had only one change in the HAART regimen. HAART prescription was in accordance to the PCDT from 2013.

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Delivery arrangements for health systems in low-income countries: an overview of systematic reviews

Ciapponi

Lewin

Herrera

et al. 2017

Cochrane Database of Systematic Reviews

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BackgroundDelivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services.ObjectivesTo provide an overview of the available evidence from up-to-date systematic reviews about the effects of delivery arrangements for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on delivery arrangements and informing refinements of the framework for delivery arrangements outlined in the review.MethodsWe searched Health Systems Evidence in November 2010 and PDQ-Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of delivery arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use, healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty or employment) and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the findings. Two overview authors independently screened reviews, extracted data, and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence), and assessments of the relevance of findings to low-income countries.Main resultsWe identified 7272 systematic reviews and included 51 of them in this overview. We judged 6 of the 51 reviews to have important methodological limitations and the other 45 to have only minor limitations. We grouped delivery arrangements into eight categories. Some reviews provided more than one comparison and were in more than one category. Across these categories, the following intervention were effective; that is, they have desirable effects on at least one outcome with moderate- or high-certainty evidence and no moderate- or high-certainty evidence of undesirable effects.Who receives care and when: queuing strategies and antenatal care to groups of mothers.Who provides care: lay health workers for caring for people with hypertension, lay health workers to deliver care for mothers and children or infectious diseases, lay health workers to deliver community-based neonatal care packages, midlevel health professionals for abortion care, social support to pregnant women at risk, midwife-led c...

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The impact of HIV clinical pharmacists on HIV treatment outcomes: a systematic review

Cited by 88 publications

References 42 publications

The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

The Role of Ambulatory Care Pharmacists in an HIV Multidisciplinary Team within a Free and Bilingual Clinic

Antiretroviral changes during the first year of therapy

Delivery arrangements for health systems in low-income countries: an overview of systematic reviews

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